He Shao-Hui, Xu Wei, Sun Zheng-Wang, Liu Wei-Bo, Liu Yu-Jie, Wei Hai-Feng, Xiao Jian-Ru
Department of Orthopaedic Oncology, Spinal Tumor Center, Changzheng Hospital, Second Military Medical University, Shanghai, China.
Department of Spine Surgery, Central Hospital of Qingdao, Qingdao, China.
Orthop Surg. 2017 May;9(2):139-144. doi: 10.1111/os.12336.
Giant cell tumor of the bone (GCTB) is a locally aggressive tumor with a certain distant metastatic rate. For sacral GCT (SGCT) and pelvic GCT (PGCT), surgery has its limitations, especially for unresectable or recurrent tumors. Selective arterial embolization (SAE) is reported to be an option for treatment in several cases, but there are few systematic reviews on the effects of SAE on SGCT and/or PGCT. Medline and Embase databases were searched for eligible English articles. Inclusion and exclusion criteria were conducted before searching. All the clinical factors were measured by SPSS software, with P-values ≤0.05 considered statistically significant. A total of 9 articles were retrieved, including 44 patients receiving SAE ranging from 1 to 10 times. During the mean follow-up period of 85.8 months, the radiographic response rate was 81.8%, with a local control and overall survival rate of 75% and 81.8%, respectively. No bowel, bladder, or sexual dysfunction was observed. Three patients developed distant metastases and finally died. Patients with primary tumors tended to have better prognosis than those with recurrence (P = 0.039). The favorable outcomes of SAE suggest that it may be an alternative treatment for SGCT and PGCT patients for whom surgery is not appropriate.
骨巨细胞瘤（GCTB）是一种具有一定远处转移率的局部侵袭性肿瘤。对于骶骨巨细胞瘤（SGCT）和骨盆巨细胞瘤（PGCT），手术存在局限性，尤其是对于不可切除或复发性肿瘤。据报道，选择性动脉栓塞术（SAE）在某些病例中是一种治疗选择，但关于SAE对SGCT和/或PGCT疗效的系统评价较少。检索了Medline和Embase数据库中的符合条件的英文文章。在检索前制定了纳入和排除标准。所有临床因素均采用SPSS软件进行测量，P值≤0.05被认为具有统计学意义。共检索到9篇文章，包括44例接受1至10次SAE治疗的患者。在平均85.8个月的随访期内，影像学缓解率为81.8%，局部控制率和总生存率分别为75%和81.8%。未观察到肠道、膀胱或性功能障碍。3例患者发生远处转移并最终死亡。原发性肿瘤患者的预后往往比复发性肿瘤患者更好（P = 0.039）。SAE的良好结果表明，对于不适合手术的SGCT和PGCT患者，它可能是一种替代治疗方法。
